The Board of Governors (B/G) Surgical Volunteerism and Humanitarian Awards Workgroup has announced the recipients of the 2016 American College of Surgeons (ACS)/Pfizer Surgical Humanitarian Award and Surgical Volunteerism Awards. As in previous years, the Workgroup received exceptional nominations, reflecting the remarkable commitment of ACS Fellows to providing care to underserved populations.
The extraordinary contributions of the award recipients are summarized in this article and will be formally recognized at the Clinical Congress 2016 in Washington, DC, during the annual B/G reception and dinner on Tuesday, October 18, at the Marriott Marquis Washington, DC. Clinical Congress attendees are invited to hear the honorees speak at a Panel Session, Humanitarian Surgical Outreach at Home and Abroad: Reports of the 2016 Volunteerism and Humanitarian Award Winners, Monday, October 17, 9:45–11:15 am, at the Walter E. Washington Convention Center, Room 102.
Surgical Humanitarian Award
The ACS/Pfizer Surgical Humanitarian Award recognizes Fellows who have dedicated much of their careers to ensuring that underserved populations have access to surgical care and have done so without expecting commensurate compensation.
Rebekah A. Naylor, MD, FACS, a general surgeon from Fort Worth, TX, will receive the Surgical Humanitarian Award for her work in significantly improving and expanding the Bangalore Baptist Hospital (BBH), Karnataka, India, during her 35 years as a medical missionary.
After completing her surgical training at Southwestern Medical Center and Parkland Hospital, Dallas, TX—the first woman resident in general surgery at both institutions—in 1973, she was appointed by the Foreign (now International) Mission Board of the Southern Baptist Convention as a missionary to India. She arrived at BBH in early 1974, where she began a missionary career that included a busy practice schedule, administrative responsibilities, and teaching.
Dr. Naylor began her work as a clinical surgeon at BBH, and in subsequent years became chief of the medical staff, an administrator, and, eventually, the medical superintendent. In her time at BBH, she greatly expanded patient care services, including the growth of the hospital from 80 beds to 160 beds. Today, BBH provides care to approximately 250,000 patients in the hospital and clinics and delivers more than 2,500 babies every year.
In the 1990s, Dr. Naylor organized training programs in four allied health disciplines, set up accredited residency training programs for physicians, and established the Rebekah Ann Naylor School of Nursing. More than 350 nurses have graduated from the school, many of whom are from low-income backgrounds, and 129 of whom are now employed at BBH. Dr. Naylor was engaged in formal teaching roles in all of the aforementioned programs.
In addition to improving the quality and availability of patient care at BBH, from 1999 to 2009 Dr. Naylor was involved in church development in the state of Karnataka. Working with the medical ministry and Indian pastors, she was able to help establish 900 churches in the state of 53 million people.
After returning to the U.S. in 2002, Dr. Naylor joined the faculty of the University of Texas Southwestern Medical Center, Dallas, where she served as clinical associate professor of surgery until her retirement in 2010. As global health care consultant for Baptist Global Response, she now mobilizes and trains health care personnel to meet medical needs worldwide. She continues to make frequent trips to India to participate in the ministry of BBH. Applying lessons learned overseas, she led the founding of Mercy Clinic in 2011, a free clinic for the underserved, uninsured population in south Fort Worth. She continues to serve this organization as board chair.
Surgical Volunteerism Awards
The ACS/Pfizer Surgical Volunteerism Award recognizes ACS Fellows and members who are committed to giving back to society through significant contributions to surgical care as volunteers. This year, four awards will be granted to the following individuals.
Sandra L. Freiwald, MD, FACS, general surgeon, Kaiser Permanente Hospital, San Diego, CA, will receive the Domestic Surgical Volunteerism Award for her work with the San Diego County Medical Society Foundation’s (SDCMSF) Project Access San Diego, which enables low-income, uninsured individuals to receive specialty care services at no cost. A surgical champion since 2008 for Project Access, Dr. Freiwald leads a team that organizes the provision of surgical care to San Diego County residents who otherwise would not have access to elective operations.
Since Kaiser Permanente San Diego partnered with SDCMSF in 2008, Dr. Freiwald has led a team for Project Access, and in that time has led 17 Saturday Surgery Days. Offered biennially at a Kaiser Permanente outpatient surgery center, these days allow surgeon volunteers to provide outpatient general surgery care, including hernia repairs, cholecystectomies, and anal fistulotomies, to patients who are unable to pay for treatment on their own. Specialists, including ophthalmologists and vascular surgeons, also are involved. Dr. Freiwald facilitates the program, recruiting surgical volunteers, screening patients, and either assisting with or performing select operations. As of the second Saturday Surgery Day in 2015, the program had provided 571 uninsured patients with specialty care.
In addition to her work with SDCMSF, Dr. Freiwald is credited with saving the San Diego Medical Center $2 million to $5 million annually by assisting in the development and implementation of the trauma patient repatriation system.
Dr. Freiwald has been involved in international surgical outreach, as well. She spent several months in 2006 and 2007 working as a general surgeon with Médecins Sans Frontiéres (Doctors Without Borders) in Monrovia, Liberia, providing emergency medical care to people affected by war and poverty. She also has participated in medical missions with Project Medishare in Haiti and in Jamaica with Kaiser Permanente Family Medicine Residents on a global health rotation.
Dr. Freiwald is assistant chief of general surgery at Kaiser Permanente San Diego; and subsection head, general surgery department, and chairperson-elect, department of surgery, Palomar Medical School, Escondido.
J. Nilas Young, MD, FACS, a cardiothoracic surgeon from Sacramento, CA, will receive one of the two International Surgical Volunteerism Awards for his work in developing, implementing, and sustaining children’s heart surgery programs throughout Russia.
Dr. Young’s volunteerism began in 1988, when he was asked to perform pro bono surgery on a seven-year-old Soviet girl with congenital heart disease in an effort to de-escalate Cold War tensions between the Soviet Union and the U.S. Soviet cardiac surgeons had given up hope of saving the girl’s life, but Dr. Young succeeded and was subsequently inundated with requests for help from the parents of sick children throughout the country. Seeing an opportunity to save the lives of many children, Dr. Young cofounded Heart to Heart International Children’s Medical Alliance, where he is medical director.
Continuing to work through the political and social unrest that came with the collapse of the Soviet Union in 1991, Dr. Young led Heart to Heart to develop what became known as Russia’s best infant heart surgery program in St. Petersburg. As his positive results became known, the St. Petersburg Ministry of Health asked him to develop surgical care for adult patients. After developing two self-sustaining heart programs, Dr. Young realized that millions of families remained without care for heart conditions, that a basic medical infrastructure upon which high-quality surgical care could be built was already in place, and that his model had proven successful, cost-effective, and could be replicated and scaled to save thousands of children. Subsequently, in 2002, he started the Into the Heartland Campaign (2002–2019) to give children throughout Russia access to lifesaving surgery.
As Heart to Heart now expands into Latin America—the first programs launched in Lima, Peru, earlier this year—the impact of Dr. Young’s efforts are being felt throughout the world. In his 27 years of volunteer surgery and program building, he has saved the lives of more than 25,000 surgical patients. Dr. Young’s contributions have been multifaceted, as a surgeon, educator, and, perhaps most importantly, a not-for-profit leader focused on building local surgical capacity.
Heart to Heart has been uniquely effective within the international humanitarian community in consistently developing self-sustaining surgical programs, and the outcomes of Dr. Young’s volunteer work through the program are profound. For example, in Municipal Children’s Hospital No. 1 in St. Petersburg, more than 9,000 children have been saved because of his work, and the program has been self-sufficient since 1999. Other successes are evident across Russia, and more are anticipated as the program expands globally.
James A. O’Neill, Jr., MD, FACS, a pediatric surgeon from Nashville, TN, will receive the second International Surgical Volunteerism Award for his work as a clinical surgeon and educator in Kenya, among other locations.
Dr. O’Neill has been involved in medical missions for more than 30 years. His early experience was in Guatemala, where he provided pediatric surgical care, and in China, where he helped to establish a children’s hospital in Shanghai.
His greatest contribution to volunteer surgical care, however, began in 2003, when he stepped down as chair of surgery at Vanderbilt University Medical Center, Nashville, TN, to dedicate his work to humanitarian activities. With the help of the ACS Operation Giving Back Program, he began a 14-year effort that has led to long-term projects at two hospitals in Kenya.
That same year, Dr. O’Neill joined a surgical team at the Naivasha District Hospital, sponsored by the Diocese of Joliet, IL. There, he worked as the hospital’s only pediatric surgeon. In addition to his significant clinical work, Dr. O’Neill’s efforts have contributed to a range of enhanced capabilities at Naivasha District Hospital, including mechanical ventilation for infants, functioning systems of surgical infection control and quality improvement, development of a trauma service and better organization of trauma care, and improved operating room efficiency.
The primary location of his practice has been in Kijabe Mission Hospital, where, since 2006, he has spent six to eight weeks annually supporting the sole full-time pediatric surgeon at the location. The surgical workload is heavy, with almost half of the patients coming from the United Nations’ Somalian refugee camps near the Kenyan border.
Humanitarian activities have increased in Africa in recent decades, and as College of Surgeons of East, Central, and Southern Africa-approved residency programs have developed, Dr. O’Neill has played a significant role in supporting the pediatric surgery residency program at Kijabe. He has helped to implement a pediatric surgery training program for African surgeons, based on the American model, to address critical surgical workforce shortages in Kenya and throughout Africa. His roles have been clinical, performing many operations himself, as well as didactic, delivering lectures three times per week during his annual residence in Kenya. He has helped to develop a curriculum that includes mock board examinations. Graduates of the pediatric surgery program now hold positions in Kenya, Uganda, Ethiopia, Sierra Leone, and Cameroon.
Barclay T. Stewart, MD, MPH, PhD, a general surgery resident from Beaufort, SC, will receive the Surgical Resident Volunteerism Award for his myriad volunteer efforts to provide care to underserved domestic and international populations through clinical services, research, and advocacy.
While a medical student at the Medical University of South Carolina, Charleston, Dr. Stewart and his colleagues organized the student-run Crisis Ministries Health Clinic for the homeless, which offered primary, basic antenatal care, and diabetic foot care; dental services; and legal assistance. The clinic continues to provide primary care.
In 2005, Dr. Stewart transitioned to global volunteerism, working at an International Rescue Committee hospital in Nepal during the nation’s civil war, assisting the surgeons and staff with burn care, outreach, and burn care education. The following year, he was in Malawi, where he co-created a referral system with condition-specific protocols to improve the timeliness of care for patients with life-threatening conditions, which resulted in a model for other rural areas.
After completing his master’s in public health, Dr. Stewart was in South Sudan, where he was asked to be the interim coordinator of a joint effort between the Malaria Consortium and the government of South Sudan. The program he ran was responsible for assessing the burden of neglected tropical diseases and delivering drug treatment to millions of people across the war-torn country.
In 2014, Dr. Stewart was awarded a two-year National Institutes of Health/Fogarty Global Health Program for Fellows and Scholars. For the first 18 months, he was in Ghana, where he collected data to integrate surgical, trauma, and burn care into the national health plan. He assessed barriers across the country, described the changing epidemiology of surgical emergencies, developed trauma care quality improvement programs, improved road safety initiatives, and created courses for district hospital staff to improve trauma care standards. He also served as a visiting chief resident in one of Ghana’s largest teaching hospitals, where more than 30,000 operations are performed annually. In addition, Dr. Stewart frequently volunteered with local surgical outreach missions and covered rural hospitals lacking a surgical care provider.
He now volunteers at the World Health Organization in Geneva, Switzerland, where he is helping to create a toolkit for other countries seeking to improve care for surgical patients.
Much of Dr. Stewart’s research is important in documenting the surgical needs of people who live in low- and middle-income countries to serve as an evidence base for advocacy. He has presented these findings at numerous conferences in the U.S. and globally; this work contributed to the community advocacy efforts that led to The Lancet Commission on Global Surgery and the World Health Assembly resolution 68.15 on strengthening emergency and essential surgical care as a part of universal health coverage.